Abstract
Hematopoietic stem cell transplantation is a therapeutic method used in a variety of malignant and non-malignant diseases. Acute lymphoblastic leukemia is the most common diagnosis indicated for this treatment in children.
History of successful transplantation has begun in the late sixties, more widespread application in the treatment of childhood leukemia occurred since the nineties. The transplantation is from the beginning focused on patients with a very poor prognosis.
Pretransplant preparative regimen using total body irradiation or high dose chemotherapy performs suppression of malignant cells clone. Gradual reconstitution of donor immune system after transplantation leads not only to recovery of anti-infective immunity but also to reduction of relapse risk due to anti-leukemic effect.
Continuously improving results of transplantation are achieved by progress in basic treatment of leukemia leading to refinement of indication criteria, better timing of transplantation in more favorable state of remission. Many other factors are involved in reducing the incidence and improving the prognosis of severe post-transplant complications.
The aim of the prospective multicenter studies is to ensure standards of care and obtain valid data enable more thorough analyses. This article summarizes the history of transplantation and current indication criteria in children with acute lymphoblastic leukemia, describes the process of preparation and transplantation, delineates issues of transplantation-related complications and their solution.